Georgia
Talk of Georgia-style full Medicaid expansion spurs bipartisan buzz at state Capitol
(GA Recorder)— The Gold Dome was aflutter during the first week of the legislative session over whether Georgia Republicans might move to fully expand Medicaid this year.
A high-ranking Republican leader elevated the issue further when he uttered the words “Medicaid expansion” during a prominent speech to Georgia’s business community Wednesday. House Speaker Jon Burns said House lawmakers “will continue to gather facts” about a “private option” for expanding Medicaid.
In particular, several GOP lawmakers have voiced interest in an Arkansas-style model, which purchases private insurance for individuals on the marketplace instead of adding more people to the state-run Medicaid program.
In a statement Friday, Republican Lt. Gov. Burt Jones sounded open to the concept. Jones has pressed for changes to the state’s business regulations for medical providers, and discussions about Medicaid expansion are happening alongside the debate over to what extent Georgia should remake its certificate of need rules.
“I have never wavered on my position that expanding access to health care, especially in rural parts of the state, should be a priority for all Georgians,” Jones said.
“The legislative process allows for different options to be presented on a variety of issues. I look forward to addressing this critical issue this upcoming session to help make access to quality health care a reality, regardless of someone’s zip code.”
This all represents what appears to be a softening of the decade-long resistance in Georgia to Medicaid expansion, which is a central piece of former President Barack Obama’s legacy. But one of the big questions of the session will be this: Does that shift in thinking extend to the governor’s mansion?
Georgia Pathways to Coverage, the governor’s partial expansion program, has enrolled about 2,300 people since launching in July. About 345,000 are thought to be eligible for the Medicaid program, according to the state’s estimate.
Kemp’s spokesman, Garrison Douglas, said Wednesday that the governor “has championed and continues to support” Pathways and Georgia Access, which is a state-run exchange set to launch later this year.
The governor did not mention Pathways in his State of the State address Thursday even as he touted other elements of his signature health care plans, like a reinsurance program that has helped lower premiums.
Pathways has attracted national attention because it made Georgia the only state to have a work requirement as part of its Medicaid program, with it only applying to those who are newly eligible.
‘We say a rose by any other name is still a rose’
The low enrollment in Pathways has ratcheted up the pressure on Georgia Republicans to change course.
Georgia – which has one of the highest uninsured rates in the country – is now one of 10 states that have not expanded Medicaid under the Affordable Care Act, with neighboring North Carolina recently expanding the health insurance program for the poor.
“This isn’t just a policy oversight; it is a moral failing,” state Sen. Nabilah Islam Parkes, a Lawrenceville Democrat, said at a press conference Thursday. “Hundreds of thousands of our people are left without adequate health care.”
But other Democrats and long-time health care advocates have expressed optimism over the recent chatter, even if the conversation is not centered on traditional Medicaid expansion.
“I’m hearing the same thing that others are hearing – that this is the year that we’re going to have some sort of Medicaid expansion,” Rep. Billy Mitchell, a Stone Mountain Democrat who chairs House minority caucus, told a reporter Thursday. “It may not be called Medicaid expansion because it’s not politically palatable to certain groups. We say a rose by any other name is still a rose.”
Rep. Michelle Au, a Johns Creek Democrat who is an anesthesiologist, said she was encouraged that talk of any kind of Medicaid expansion is now happening in Georgia.
“Even having this conversation at all, and considering something in a serious way, is already way better than anything that we’ve seen for a decade,” Au said in an interview.
Au led a Democratic caucus-organized hearing on Medicaid expansion that filled a meeting room and had people standing in the hallways to hear health care experts, hospital representatives and others talk about the impact of Medicaid expansion on the state’s economy and the health of Georgians.
Au, who is a leading Democratic voice on health care issues in Georgia, has regularly held educational forums on Medicaid expansion. But this year’s event was different.
“There’s a feeling in the air: something has changed, and it’s like, we’re really talking about this. This might happen,” Au said. “And many of our holdout-state neighbors have recently changed – states that we have a lot in common with. So, it’s not unreasonable to go down this path to think that there is a chance this could happen.”
Scott Raynes was among the speakers at Au’s meeting. Raynes is president and CEO of Brunswick-based Southeast Georgia Health System and was a member of the House committee that looked at ways to modernize the state’s certificate of need regulations.
“Let’s not get hung up on the fact that we are one of the last 10 or 11 to even explore this,” Raynes said. “Let’s take advantage of the learnings of those states before us and make a good decision. A good economic decision, a decision that is really apolitical if you will, and do what’s right on behalf of the citizens of the state of Georgia, and frankly, help the industry of health care within it.”
Laura Colbert, executive director of Georgians for a Healthy Future, which advocates for Medicaid expansion, had this message for those who attended the organization’s Health Care Unscrambled event held Thursday: “I’m not going to count our chickens before they hatch – we don’t have expansion yet – but it’s coming.”
Georgia Pathways
The governor has proposed spending $1.7 million in this year’s budget to integrate Pathways into the state’s eligibility system for Medicaid and other public aid services, which is a move that is intended to increase enrollment in the program and improve the effectiveness of caseworkers who are processing applications, according to the governor’s Office of Budget and Planning.
The funding would also connect the state’s system to Georgia Access as Georgia moves toward a state-based exchange for health insurance under the Affordable Care Act.
Pathways slightly expanded eligibility for Medicaid coverage in Georgia but also requires participants to complete 80 hours each month of work, school or other qualifying activity, and critics have long warned that the reporting requirements to show the hours were completed would create a paperwork burden.
The program was approved under the Trump administration and then delayed by the Biden administration. Georgia moved forward with launching the program in July after successfully challenging the federal government in court.
The program’s federally approved waiver expires in the fall of 2025.
During a conversation about Medicaid expansion at the Health Care Unscrambled event Thursday, Savannah Republican Sen. Ben Watson praised the state’s reinsurance program and urged health care advocates to help enroll people in Pathways.
“The one that’s been a bit of a challenge, and I would challenge you to help our patients to get enrolled, is that 100% on down,” said Watson, who chairs the Senate Health and Human Services Committee.
As Pathways is being rolled out, an army of state workers is also in the process of checking the eligibility of all 2.8 million people covered by Medicaid after the end of a pandemic-era federal rule that protected coverage during the public health crisis. Hundreds of thousands of Georgians are expected to lose coverage as part of what’s known as the unwinding.
Georgia
Georgia RB Trevor Etienne is out for Saturday's SEC clash with Tennessee
No. 12 Georgia will be without one of its top offensive weapons for Saturday’s showdown with No. 7 Tennessee. Running back Trevor Etienne was listed as out with a rib injury on the SEC’s injury report after being listed as questionable throughout the week.
Etienne, who transferred to Georgia after two seasons at Florida, is the Bulldogs’ leading rusher with 477 yards and seven touchdowns, with an additional 140 receiving yards on 23 catches. He suffered the injury to his ribs in Week 10’s 34-20 win over the Gators. Etienne attempted to play in last week’s 28-10 loss to Ole Miss, but participated in only six snaps.
Georgia’s running back depth was already thin and Etienne’s injury only makes the situation more dire. Freshman Nate Frazier is the team’s second-leading rusher with 333 yards and three touchdowns on 75 carries. However, fellow freshmen Dwight Phillips Jr. and Chauncey Bowens have seven touches between them this season.
Branson Robinson has missed three games with a knee injury, junior Cash Jones is listed as questionable on this week’s injury report and Roderick Robinson II has not played this season due to turf toe.
As a result, Georgia is second to last among SEC teams in rushing with 1,117 total yards and yards per game (124.1), and 10th in the conference with 3.35 yards per carry. The lack of a consistent rushing attack has affected the performance of quarterback Carson Beck, who has thrown 12 interceptions this season — twice as many as he threw last year.
At 5-2 in the SEC (7-2 overall), a loss would likely knock Georgia out of the College Football Playoff picture. Tennessee could arguably afford a defeat at 8-1 (5-1 in conference).
Tennessee quarterback Nico Iamaleava is listed as questionable while reportedly in the concussion protocol during the week.
Georgia
Georgia's Fulton County Jail violates rights of detainees with violence and filth, feds say
The Justice Department has found that egregious jail conditions in Georgia’s Fulton County — including pest infestation, malnourishment, a lack of adequate medical care and rampant violence that contributed to multiple deaths — violate the constitutional rights of people in custody.
The department on Thursday announced its findings from a civil rights investigation that had opened in July 2023 into conditions of Fulton County Jail in Georgia.
It found that Georgia officials violated the rights of those incarcerated by failing to protect them from violence, failing to provide humane living conditions, neglecting adequate medical and mental health care, having a pattern of excessive force and confining detainees in “dangerous restrictive housing conditions without due process.”
The investigation came after the death of Lashawn Thompson, 35, in September 2022, that sparked public outrage. His body was found malnourished in a bedbug-infested cell in the jail’s psychiatric wing, and a private autopsy found he was neglected to death.
The 105-page report details the serious conditions found at the jail —described as long-standing, filthy and dangerous — as well as remedial measures that Fulton County officials should implement.
Fulton County and the Fulton County Sheriff’s Office did not immediately respond to NBC News’ request for comment Thursday.
Fulton County Jail: Home to stabbings, assaults, pests and a lack of care
The lengthy report presented a staggering portrait of violence and death at the Fulton County Jail.
From 2022 to the present, six incarcerated people have died in violent attacks at the jail, the report said. Over 300 stabbings involving contraband and makeshift weapons were also reported at the jail in 2023. Four deaths by suicide have also been reported in the past four years, including as recently as April, according to the report.
The report found that Fulton County Jail failed to protect detainees from the risk of harm from violence and sexual violence. Assaults are carried out in the jail using makeshift weapons and the jail has inadequate practices for reporting and responding to sexual violence.
The report said that killings, stabbing and assaults are common at the jail. In less than 24 hours in August 2023, at least seven people were stabbed and one was killed at the jail in an outburst of violence that spanned five units and three floors, it noted.
Further, Fulton County Jail deputies and detention officers use force against incarcerated people without adequate justification, including deploying Tasers without reasonable cause, the document said.
The facilities were found to be in a state of “serious disrepair” and living conditions are “hazardous and unsanitary.”
Housing units are flooded with water from broken toilets and sinks, there are cockroaches, rodents and other pests, and the jail took “insufficient steps to control infestations.” Cells are described as “filthy and unhygienic with dangerous exposed wires.”
The jail also failed to provide enough food, food preparation and service are not sanitary, and detainees have suffered from malnourishment and pest infestation.
The report found that medical and mental health care also did not meet constitutional standards: there were gaps in medication administration, there’s a lack of security staff and when medical emergencies happen the jail fails to provide appropriate care,
And the jail fails to adequately treat serious mental health needs and prevent a risk of suicide. It’s a dire situation, the report found, as those with mental health needs are “overrepresented” in the jail population, yet the jail environment “exacerbates symptoms of mental illness.”
The report found that the jail placed people in isolation without adequate monitoring, and placement in restrictive housing discriminates against people with mental health disabilities.
Further, there are 17-year-old boys and girls are in the jail, as Georgia’s juvenile justice system’s jurisdiction ends at 16. These teens are subjected to violence, excessive force, experience sexual abuse and are uniquely harmed in restrictive housing like isolation, the report said.
The jail also fails to provide special education services to those 17-year-olds who are entitled to them — in violation of the Individuals with Disabilities Education Act.
Lashawn Thompson
Thompson, who had a history of mental illness and was unhoused, died three months in the jail after his arrest.
The report said that Thompson was accused of spitting at a Georgia Tech police officer and was arrested on a simple battery charge, and was held on an old warrant.
The jail failed detainees like Thompson with mental health needs, the report found.
It said that four Black men, including Thompson, who all had serious mental health needs died in the jail’s mental health unit in under a year. Within weeks of the investigation opening, six more Black men died at the jail.
Thompson’s death gained public attention after attorneys for his family released photos of his face and body covered in insects.
In August 2023, the family of Thompson reached a settlement with Fulton County for an undisclosed amount.
In announcing Thursday’s report, Attorney General Merrick Garland said: “Lashawn Thompson’s horrific death was symptomatic of a pattern of dangerous and dehumanizing conditions in the Fulton County Jail.”
“The unconstitutional and unlawful conditions at the Fulton County Jail have persisted for far too long, and we are committed to working with Fulton County and the Fulton County Sheriff’s Office to remedy them,” he added.
Jail grapples with overpopulation and mental health needs
Fulton County, which includes most of Atlanta, is the largest county in the state. The jail has a main facility and three annex facilities, and the population is nearly all people with pending criminal charges.
The jail has struggled to “address a ballooning population and overcrowding,” the report said.
Black people are overrepresented in the jail compared with the county’s population. People with mental health needs are also overrepresented in the jail population.
The report noted that “deaths and serious injuries remain prevalent at the jail. Thus far in 2024, three men at the Main Jail have died: one of a suspected drug overdose, one by stabbing and one by suicide.”
“Detention in the Fulton County Jail has amounted to a death sentence for dozens of people who have been murdered or who died as a result of the atrocious conditions inside the facility. It’s not just adults but also children who are subjected to conditions and treatment that violate the constitution and defy federal law,” Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division said.
She noted that many held have not been convicted or are serving short sentences for misdemeanors.
The Department of Justice said that the U.S. Attorney General can file a lawsuit in federal court seeking court-ordered remedies. The department provided Fulton County and the local sheriff’s office with a written notice outlining the minimum remedial measures to address the alleged violations.
“The County will work with the Justice Department toward a cooperative resolution,” the release said.
Georgia
Georgia's controversial College Football Playoff ranking a reminder that this is supposed to be hard
This week, the College Football Playoff selection committee deigned to suggest that the Georgia Bulldogs — who have won two of the last three national championships and began this very season as the preseason No. 1 in the AP poll — might not make the final 12-team field.
If you plugged in the teams from this week’s CFP rankings into a bracket, you’d quickly discover that No. 12 Georgia would actually be the first team out, because No. 13 Boise State would slide into the field as the 12 seed, with the fifth highest-ranked conference champion assured to make the field. Now, this week’s rankings are not the real ones. They’re made for television, and there’s so many more data points still to be collected before Selection Sunday (Dec. 8). That’s when we’ll know who is truly in and out.
But the level of scrutiny that the committee has received to date shouldn’t be surprising. Deciding between teams in the 5-12 range is much harder than simply ranking 1-4 as it has for the past decade. There are always teams with obvious flaws when you get to the bubble. This particular chaos-filled regular season only underscores that.
Still, it was jarring to see the Bulldogs as the first team out of the bracket — even though they’re fresh off an 18-point loss to Ole Miss, their second loss of the season. Carson Beck hasn’t played well in more than a month, turning the ball over more than any other quarterback in the SEC. Even the defense, a calling card of Kirby Smart teams, has gotten gashed at times this season.
Logically, it makes sense that two-loss Georgia might miss the Playoff. Four SEC teams are in this week’s projected bracket! It’s not like the league itself is being slighted, even though fans in the southeast certainly feel a way about the Big Ten having four teams ranked in the committee’s top five. The ACC and Big 12 are both staring down the very real possibility of being one-bid leagues.
So, why the uproar about Georgia? Part of it has to do with the fact that it’s Georgia. With Nick Saban retired, Kirby Smart has assumed the mantle as the flag-bearer of the sport, his level of success and recent titles setting the new gold standard. The other part is that the ‘Dawgs have played the nation’s toughest schedule, per ESPN’s strength of schedule metrics. They have lost two games (and nearly lost to Kentucky) because they have played opponents that are harder to beat — and fans want that to offset or discount the losses.
“Their offense hasn’t been consistent — the committee discussed that,” selection committee chair Warde Manuel said. “They’ve struggled with some turnovers. The defense has been solid, although in the loss to Ole Miss, we felt that that plays a factor into with the offense struggling; their defense was on the field quite a bit.”
Manuel also pointed out that because the committee adhered to its principle of head-to-head results mattering, Georgia had to be slotted behind the two teams it had lost to (Alabama and Ole Miss). Again, this is all pretty logical.
Still, it prompted something of an existential crisis among those who root for the Bulldogs and among those who believe the SEC is the nation’s premier conference. They want to believe that a two-loss Georgia team is a lock for the CFP. They want to believe that a three-loss Georgia team can make the field, too.
Georgia currently first out in latest CFP ranking
Nicole Auerbach and Joshua Perry react to the latest College Football Playoff ranking, including the Georgia Bulldogs currently sitting outside of the tournament.
We still don’t know how conference championship games are going to affect the final bracket. CFP executive director Rich Clark and his staff have suggested that they don’t expect the selection committee to penalize the teams that lose in their conference championship games, because those teams would be playing an additional game compared to the other teams in the at-large pool that they’ll be compared to.
So, in theory, if Georgia beats Tennessee this weekend and eventually somehow ends up in Atlanta for the SEC championship game, it could suffer a third loss. But would that be viewed as a third loss? Or could the committee truly set that aside? It’s something that sounds great in theory, but I have a hard time believing the committee won’t make note of the “3” it sees in the loss column every time it looks at the Georgia team page.
And if the loser of the SEC title game isn’t penalized, then shouldn’t that mean the same for the loser of the Big 12 and ACC championship games? If Miami is comfortably in the bracket heading into the ACC title game and BYU the same heading into the Big 12 title game, why do we think losses could knock both teams out of the bracket as at-large candidates?
So much of the conversation around the CFP right now boils down to the value of brands. We’re talking about Georgia this way because it’s Georgia. We’re talking about two-loss SEC teams this way because they’re in the SEC.
Takeaways from Georgia, Miami losses in Week 11
The Big Ten College Countdown crew reacts to some of the biggest games around college football in Week 11, including Ole Miss topping Georgia and Georgia Tech handing Miami its first loss of the season.
If any other team had Georgia’s resume, a turnover-prone quarterback and a general downward trajectory, we would have no problem with them being on the wrong side of the bubble. If SMU’s helmets looked like Michigan’s but had the same resume — a top-20 win and a three-point loss to the nation’s No. 6 team — it seems quite that the Mustangs would be in the bracket, as we see teams like Texas, Penn State and Indiana all ranked inside the top six despite a lack of signature wins to anchor their resumes. And we still aren’t actually sure if any of those teams can weather a loss and still make the final bracket.
Ultimately, this season is about testing our patience. There’s a lot we don’t know about a new format and a process that is not at all transparent. But that’s what everyone signed up for with a 12-team bracket in the era of megaconferences. Georgia being the team that’s not in the field isn’t something any of us would have predicted back on Labor Day. But in a season filled with surprises, this is perhaps a shocker we should have seen coming.
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